In Istanbul

Helen Mackreath

Last summer, a young Syrian woman in Istanbul gave birth to a baby boy with a severe umbilical hernia, which required surgery. But after three months he still didn’t have an ID card, and doctors wouldn’t perform surgery without it.

Songül, one of their Turkish neighbours, took the baby and his mother to all the hospitals and emergency clinics she knew of, to no avail. One hospital took a blood sample and gave them a referral for surgery, but they were turned away for not having an ID. They were told to go to the police station to get a copy of the baby’s birth certificate. They did, but the hospital wouldn’t accept it – only an ID card would do, they said.

‘I saw at least three or four Syrian children in front of a surgeon, waiting in their mother’s arms, in a faint, to be operated on for urgent muscle rupture operations,’ Songül told me. ‘They needed operations but they couldn’t have them because they didn’t have identity cards. If the doctors attend to them, they get questioned by inspectors. The police told us: “Wait another three months for your ID card, and come every month to check.” The hospital said: “If the muscle ruptures suddenly and if the baby goes purple, then we can operate because then it’s an emergency situation.” But if the muscle ruptures, then he will have a lifelong problem – he would need a catheter for his whole life.’ Six months later an NGO paid for the baby to be treated at a private hospital.

It takes at least six months for Syrian babies born in Turkey to get identity cards. The procedure includes security checks on their parents. The father’s name may not be recorded on the birth report if he is not present at the birth and the mother does not have their marriage or his birth certificate: this may cause citizenship problems for the child later, since Syrian nationality is usually based on paternity. The parents must take the birth report to the police, who record the newborn as a ‘guest’ in Turkey. The babies of Syrians who aren’t registered with the Turkish authorities are born with no official status and are effectively stateless.

According to official figures, there are more than 2.8 million Syrian refugees in Turkey; nearly 400,000 of them are under five years old. Their rights include access to free healthcare. All Syrians in Turkey, whether they’re registered with the authorities or not, are supposedly entitled to emergency healthcare, but they don’t always get it. In Antalya province at the beginning of the year, Ali Izzettin Ahmed, a seven-year-old Syrian child, died after being turned away from four hospitals. He had a high fever, but no valid ID. There’s a polio immunisation programme for children under five, but it’s haphazardly carried out.

Some refugees took matters into their own hands. Last month I visited a polyclinic run by Syrian doctors out of a small two-storey building on a tree-lined side-street in Istanbul’s Zeytinburnu district. They see 100 patients a day. The whole space is completely white – leather seats, lino floor, curtains, paint, coats – ‘So we can make sure it is clean,’ the doctor said. Aged 31, he came to Istanbul two years ago. He used to work as a teacher in a Syrian school (or 'temporary education centre') before opening the clinic last year. There’s a dentist, a gynaecologist and, downstairs, a laboratory with a single microscope. Shifts are six hours, split between two doctors. Their salaries are paid by a Syrian NGO. They have a basic supply of medicine. They can’t perform surgery though; it isn’t sterile enough for that.

The Syrian polyclinics have been an important part of the healthcare provision for refugees, especially those who are unregistered, don't speak Turkish or are more comfortable seeing a Syrian doctor. But the government recently started shutting them down, including a large one in Fatih, Istanbul, that had been given a new building – by the government – last summer. The closures look set to continue. The Ministry of Health is planning to reopen some under its supervision, keeping the Syrian doctors, but it isn't clear how they will choose which will be allowed to continue operating.

Additional reporting by Şevin Gülfer Sağniç.